M BAIRY1, FHW SEE 2
1Tan Tock Seng Hospital, Singapore; 2Yong Loo Lin School of Medicine, Singapore.
Aim: To apply the keGFR formula to estimate GFR in the non steady state and detect AKI
Background: The AKIN classification of AKI has its limitations . Estimating GFR when the Creatinine is rapidly changing as in AKI has been a challenge. We employ the keGFR formula by Chen to derive the keGFR and detect AKI in a non ICU inpatient setting.
Methods: 250 consecutive adult patients admitted to the Medical wards were screened. Patients with a change in creatinine of >4.3%(Biological Variation) were included in the study. The keGFR formula by Chen was applied to this cohort after calculating the Volume of distribution (Vd) for patients individually. A fall in keGFR of 25% or more was considered as AKI. The AKIN criterion was also applied to this cohort and compared with the keGFR criterion.
Results: All patients (31) diagnosed to have AKI by keGFR satisfied the AKI criteria by AKIN. AKIN diagnosed an additional 19 patients to have AKI. However, all of these had an elevated creatinine level on admission hence requiring the incorporation of baseline creatinine by AKIN which is not part of the keGFR formula. All patients with in-hospital AKI were detected by both the criteria.
Conclusions: The keGFR formula can be applied to estimate GFR in the non steady state. A keGFR based criterion successfully detected in hospital AKI in this study